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April 2013 Briefing - Critical Care

Here are what the editors at HealthDay consider to be the most important developments in Critical Care for April 2013. This roundup includes the latest research news from journal articles, as well as the FDA approvals and regulatory changes that are the most likely to affect clinical practice.

Outcomes Often Good for Extremely Premature Infants

TUESDAY, April 30 (HealthDay News) -- About three-quarters of infants born extremely prematurely who receive active care have mild or no neurodevelopmental disability at 2.5 years of age, according to a study published in the May 1 issue of the Journal of the American Medical Association, a theme issue on child health.

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FDA Approves Kcentra to Reverse Anticoagulation

TUESDAY, April 30 (HealthDay News) -- Kcentra (prothrombin complex concentrate, human) has been approved by the U.S. Food and Drug Administration to treat severe acute bleeding in adults after administration of warfarin and similar products.

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Multicenter Study Links Peri-Op SSRI Use to Adverse Outcomes

TUESDAY, April 30 (HealthDay News) -- Perioperative use of selective serotonin reuptake inhibitors (SSRIs) is associated with adverse outcomes, including in-hospital mortality, bleeding, and 30-day readmission, according to a multicenter study published online April 29 in JAMA Internal Medicine.

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Renewed Efforts From AAFP to Repeal OTC Provision in ACA

TUESDAY, April 30 (HealthDay News) -- Members of the American Academy of Family Physicians (AAFP) and other medical associations are urging further consideration of Section 9003 of the Patient Protection and Affordable Care Act (ACA) that requires holders of tax-preferred health care accounts to obtain a physician's prescription to use funds from those accounts to pay for over-the-counter (OTC) medications. The concerns have been laid out in a letter to the chair and the ranking member of the House Committee on Ways and Means.

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FDA Announces New Network to Focus Exclusively on Patients

MONDAY, April 29 (HealthDay News) -- The U.S. Food and Drug Administration has announced the launch of a new interactive tool for educating patients, their advocates, and consumers about the processes involved in medication development.

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Medical Interns Spending Less Time With Patients

FRIDAY, April 26 (HealthDay News) -- Medical interns are spending less time with patients and more time at a computer since new rules limiting total work hours were instituted in 2011, according to a study published online April 18 in the Journal of General Internal Medicine.

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Report Updates Impact of Hypoglycemia in Diabetes

FRIDAY, April 26 (HealthDay News) -- An update of the current state of knowledge about the impact of hypoglycemia on patients with diabetes reviews outcomes, strategies to prevent hypoglycemia, and current knowledge gaps, and has been published in the May issue of Diabetes Care.

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Device Detects Blood Fungal Infections Rapidly

THURSDAY, April 25 (HealthDay News) -- A small, portable device can detect Candida bloodstream infection, an often fatal fungal bloodstream infection, rapidly and accurately, according to a study published in the April 24 issue of Science Translational Medicine.

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Physicians Less Empathetic in Talking to Heavy Patients

THURSDAY, April 25 (HealthDay News) -- Primary care physicians (PCPs) are less likely to bond with overweight and obese patients, according to research published online March 20 in Obesity.

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Prevalence, Costs of Heart Failure Estimated for 2030

THURSDAY, April 25 (HealthDay News) -- The impact of heart failure is likely to increase, with more than eight million U.S. adults anticipated to have heart failure by 2030, at an estimated total cost of $70 billion, according to a study published online April 24 in Circulation: Heart Failure.

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Natural Ventilation Effective in 'Nightingale' Wards

THURSDAY, April 25 (HealthDay News) -- For large environments with multiple openings, natural ventilation is effective, and can be supplemented with extract fans in cold weather, according to a study published in the July issue of Building and Environment.

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Diagnostic Errors Are the Leading Type of Malpractice Claim

WEDNESDAY, April 24 (HealthDay News) -- In the past 25 years, diagnostic errors have been the leading type of malpractice claim and account for the highest proportion of total payments, according to a study published online April 22 in BMJ Quality & Safety.

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Doc Describes Medical Tent Experience of Boston Marathon

WEDNESDAY, April 24 (HealthDay News) -- The experience of a physician in the medical tent at the Boston marathon provides insight into the impact of the bombings on medical professionals at the scene; the perspective piece was published online April 23 in the New England Journal of Medicine.

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Peri-Noncardiac Op Exposure to β-Blockers Improves Outcome

TUESDAY, April 23 (HealthDay News) -- For patients undergoing major noncardiac surgery with two or more Revised Cardiac Risk Index factors, early exposure to β-blockers is associated with improved 30-day postoperative outcome, according to research published in the April 24 issue of the Journal of the American Medical Association.

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Patient Characteristics Impact CABG-PCI Treatment Effect

TUESDAY, April 23 (HealthDay News) -- In the community setting, coronary artery bypass graft (CABG) surgery is associated with reduced mortality versus percutaneous coronary intervention (PCI), with the association affected by patient-level characteristics, according to a study published in the April 23 issue of the Annals of Internal Medicine.

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Firearms Account for About 2 Percent of Child Injuries

TUESDAY, April 23 (HealthDay News) -- In level 1 trauma centers in Denver and Aurora, Colo., about 2 percent of pediatric injuries result from firearms, according to a research letter published in the April 24 issue of the Journal of the American Medical Association.

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Interdisciplinary Model Ups Care of Hospitalized Elderly

TUESDAY, April 23 (HealthDay News) -- For elderly patients, admission to the Mobile Acute Care of the Elderly (MACE) service, a novel model of care delivered by an interdisciplinary team, correlates with lower rates of adverse events and shorter hospital stays, compared with usual care, according to a study published online April 22 in JAMA Internal Medicine.

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Outcomes No Worse With Home Call for Surgical Interns

MONDAY, April 22 (HealthDay News) -- For surgical interns, being on call from home is not associated with increased rates of postoperative morbidity or mortality, according to a study published in the April issue of JAMA Surgery.

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Dangers of the 'Cinnamon Challenge' Need Emphasis

MONDAY, April 22 (HealthDay News) -- With the increasing popularity of the "Cinnamon Challenge," especially among adolescents, the potential dangers need to be emphasized, according to a perspective piece published online April 22 in Pediatrics.

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Lupus Ups Risk of Spontaneous Subarachnoid Hemorrhage

FRIDAY, April 19 (HealthDay News) -- Patients with systemic lupus erythematosus (SLE) have an increased risk of spontaneous subarachnoid hemorrhage (SAH) and increased mortality after SAH, according to a study published in the April issue of Arthritis Care & Research.

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Patient-Centered Decision Making Ups Health Outcomes

FRIDAY, April 19 (HealthDay News) -- Patient-centered decision making (PCDM) is associated with improved health care outcomes, according to a study published in the April 16 issue of the Annals of Internal Medicine.

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Guidelines Issued Relating to Online Medical Professionalism

THURSDAY, April 18 (HealthDay News) -- Physicians should be aware of the benefits on online media and should recognize the implications for patient confidentiality and public perception, according to a position paper published in the April 16 issue of the Annals of Internal Medicine.

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Family-Centered Teaching Rounds Good for Patients, Students

THURSDAY, April 18 (HealthDay News) -- Teaching and conducting rounds in the presence of patients and their families can be beneficial for patients and learners, according to research published online April 15 in Pediatrics.

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Relative Proportion of MRSA Increasing in S. aureus Isolates

THURSDAY, April 18 (HealthDay News) -- The relative proportion of methicillin-resistant Staphylococcus aureus (MRSA) is increasing in S. aureus isolates, and methicillin-sensitive S. aureus (MSSA) is becoming increasingly resistant to antibiotics, according to a study published in the April issue of JAMA Dermatology.

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Glutamine, Antioxidants No Benefit to Critically Ill Patients

WEDNESDAY, April 17 (HealthDay News) -- For critically ill patients with multiorgan failure, early supplementation with glutamine or antioxidants does not improve clinical outcomes, according to a study published in the April 18 issue of the New England Journal of Medicine.

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Community Benefit Spending Varies for Tax-Exempt Hospitals

WEDNESDAY, April 17 (HealthDay News) -- There is considerable variation in the level of community benefit expenditure by tax-exempt hospitals, according to a study published in the April 18 issue of the New England Journal of Medicine.

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Effect of Surgical Complications on Hospital Finances Analyzed

WEDNESDAY, April 17 (HealthDay News) -- The occurrence of surgical complications is associated with higher hospital contribution margins, which vary by payer types, according to research published in the April 17 issue of the Journal of the American Medical Association.

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Presenting Fee Data to Docs Cuts Number of Tests Ordered

WEDNESDAY, April 17 (HealthDay News) -- Presenting fee data to providers at the time of laboratory test orders is associated with a small reduction in the number of tests ordered, according to a study published online April 15 in JAMA Internal Medicine.

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Shock Waves Improve Coronary Stem Cell Treatment

TUESDAY, April 16 (HealthDay News) -- In patients with chronic heart failure, cardiac shock wave pretreatment before intracoronary infusion of bone marrow-derived mononuclear cells (BMCs) significantly but modestly improves heart function, according to a study published in the April 17 issue of the Journal of the American Medical Association.

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Speech Details Practices to Improve U.S. Health Systems

THURSDAY, April 11 (HealthDay News) -- There are specific steps health care providers and policymakers should take to create high-quality, patient-centered care at lower costs, according to remarks made in an April 9 speech to the National Press Club.

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Risk of Comorbidities Up With Hypoglycemia in T2DM

MONDAY, April 8 (HealthDay News) -- For patients with type 2 diabetes, hypoglycemia, regardless of its severity, correlates with a significantly increased risk of cardiovascular events, all-cause hospitalization, and mortality, according to research published in the April issue of Diabetes Care.

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EEG Proves Useful in Detection of Causes of In-Hospital Spells

FRIDAY, April 5 (HealthDay News) -- Seizures are common among hospitalized patients who undergo electroencephalography (EEG) due to spells or altered mental status, according to a study in the April issue of Mayo Clinic Proceedings.

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Statins Show Protective Effect Against Acute Kidney Injury

FRIDAY, April 5 (HealthDay News) --Initiating a statin prior to coronary artery bypass grafting (CABG) surgery may modestly reduce the risk of acute kidney injury (AKI) post-CABG, especially in patients less than 65 years old, according to research published March 15 in The American Journal of Cardiology.

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Chronic Pain Syndromes Are Common After Ischemic Stroke

FRIDAY, April 5 (HealthDay News) -- About 10 percent of patients develop chronic pain syndromes post-stroke, and these patients are more likely to have increased functional dependence and cognitive decline, according to research published online April 4 in Stroke.

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Rural Hospital Mortality Rates Climbed From 2002-2010

WEDNESDAY, April 3 (HealthDay News) -- Thirty-day mortality rates for patients admitted to critical access hospitals (CAHs; designated hospitals for individuals living in rural communities) increased from 2002 to 2010 compared with patients admitted to other acute care hospitals, according to a study published online April 2 in the Journal of the American Medical Association.

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After Chest Pain, Outcomes Are Better With Cardiologist's Care

TUESDAY, April 2 (HealthDay News) -- Patients with high cardiovascular risk seen for chest pain have better outcomes if they receive follow-up from a cardiologist rather than a primary care physician or no physician follow-up, according to a study published online April 1 issue of Circulation.

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Most Partners of U.S. Docs Satisfied in Their Relationships

MONDAY, April 1 (HealthDay News) -- Most spouses/partners of U.S. physicians report being satisfied with their relationships, with satisfaction linked to time spent together each day, according to research published in the March issue of the Mayo Clinic Proceedings.

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